What Are the Causes of Shoulder Pain During Pregnancy?

If you’re expecting, you know the thrilling bodily changes often come with a few unwelcome side effects. These can include persistent fatigue and strange sensations like aches, fluttering, or tingling in your abdomen and back.

Pregnancy can also produce discomfort in areas that seem distant from where baby is growing. You might be surprised to discover that new shoulder pain could be related to your pregnancy.

Shoulder discomfort (like other pains) is often a normal part of pregnancy. However, in some cases, shoulder pain — especially when it occurs with other signs — may indicate something more concerning. The timing of shoulder pain in your pregnancy matters.

Here’s what you need to know and what steps to take if you experience shoulder pain while pregnant.

Typical reasons for shoulder pain in pregnancy

Shoulder pain can arise at any stage of pregnancy for many reasons. Most often, it’s benign.

It commonly stems from alterations in your muscles and joints. Possible triggers include straining your back, sleeping awkwardly, poor posture, and standing for extended periods.

Usual (non-alarming) shoulder pain during pregnancy often feels like stiffness or mild soreness. It should not present as intense, sharp, or stabbing pain.

First trimester

Your body produces a hormone called relaxin even before pregnancy is confirmed. This hormone plays several roles throughout pregnancy and helps your body adapt for the growing baby.

Relaxin loosens connective tissues, which can cause aches in various places — including the shoulders.

Second trimester

As your baby grows, your body changes to support this new life. In the second trimester your bump becomes more visible and your weight distribution and body shape shift to accommodate the pregnancy.

Those physical changes influence how you sleep, sit, stand, and walk. In fact, a small medical study showed that individuals in their second trimester walked more slowly than nonpregnant people.

So, even if you don’t yet look very pregnant, your body mechanics are changing and affecting your muscles. That can cause muscle soreness, including shoulder pain.

Third trimester

By the third trimester your body has undergone many adaptations as your baby prepares for delivery. Your body accommodates the extra weight — sometimes by increasing the curvature of your spine.

The same 2015 study compared the spines of 19 women in their third trimester with those not pregnant and found that the lumbar region in pregnant women was more curved.

This increased lordosis — an “S” shape in the spine — helps balance the added weight of baby, blood, and other bodily changes. These spinal shifts can alter back and shoulder muscle function, causing typical shoulder aches during pregnancy.

Relaxin continues to loosen ligaments in the third trimester so pelvic joints can widen for birth. Other joints, including those in the shoulders, also become more lax.

This ligament loosening, combined with changes in posture, sleep position, and walking mechanics, can contribute to common shoulder pain in late pregnancy.

More concerning reasons for shoulder pain in pregnancy

More serious causes of shoulder pain can occur at any point in pregnancy, so report shoulder pain or unusual symptoms to your healthcare provider.

First trimester

If you experience shoulder pain very early on, one possible cause is an ectopic pregnancy. This occurs when the embryo implants outside the uterus, most commonly in a fallopian tube.

Symptoms of an ectopic pregnancy typically appear between weeks 4 and 12. They may arise before you know you’re pregnant or before you’ve had medical evaluation.

An ectopic pregnancy can produce shoulder-tip pain, felt as a sudden, odd ache between the shoulder and arm.

This type of shoulder pain actually results from internal bleeding irritating the nerves that control the diaphragm. The irritated nerve transmits sensations from both the diaphragm and shoulder area, causing “referred” pain in the shoulder.

Other symptoms that often accompany an ectopic pregnancy include:

• abdominal pain
• lightheadedness or fainting
• nausea or vomiting
• vaginal bleeding
• abdominal swelling or fullness
• pain on bowel movements
• diarrhea
• cramping or one-sided pain

An ectopic pregnancy is an emergency and needs immediate medical care.

Second and third trimesters

Gallstones

The hormones associated with pregnancy can also lead to side effects — rarely, this includes gallstone formation. Many people with gallstones have no symptoms, but a stone that becomes lodged in a bile duct can trigger severe problems.

Right shoulder pain during pregnancy may indicate gallstones. Other warning signs include:

• nausea and vomiting
• intense pain in the upper right abdomen that worsens
• sudden worsening pain in the middle of the abdomen
• back pain between the shoulder blades

Pain from gallstones can last from minutes to hours. In severe cases, fever and jaundice (yellowing of skin and eyes) can occur.

Serious blockages or complications might require surgical removal of the gallbladder, but many cases can be managed with lifestyle changes such as:

• eating regular meals
• adding more fiber to your diet
• avoiding fried foods
• cutting back on sugary foods
• reducing simple carbohydrates
• doing light daily exercise

Preeclampsia

Shoulder pain in the second or third trimester can be a symptom of preeclampsia — a serious condition marked by high blood pressure and other complications during pregnancy or postpartum.

Symptoms generally emerge after 20 weeks, though they can appear earlier. In addition to shoulder pain, signs of preeclampsia may include:

• facial swelling
• swollen hands
• persistent headaches
• visual changes
• blurred vision or seeing floaters
• light sensitivity
• sharp pain when taking a deep breath
• upper abdominal pain
• pain on the upper right side
• nausea and vomiting
• shortness of breath

Treatment for preeclampsia includes frequent blood pressure monitoring and regular medical follow-up. You may need medication, a low-sodium diet, and bed rest to control blood pressure.

If symptoms don’t improve, your provider may advise early delivery. Most people recover soon after giving birth.

How to ease common shoulder pain during pregnancy

Most pregnancy-related aches, including shoulder pain, can be managed with simple measures. Relief may come from:

• gentle stretches
• massage — ideally with a therapist experienced in pregnancy
• a warm (not hot) bath
• warm or cold packs
• posture support
• a pregnancy support pillow — here are some good options

Ask your healthcare provider which pain reliever is safe for you. Acetaminophen (Tylenol) is generally considered acceptable for occasional use.

For more serious causes — like ectopic pregnancy, gallstones, or preeclampsia — you’ll need targeted medical treatment from your clinician.

When to contact your doctor

Always notify your provider if you notice unusual, new, or severe symptoms during pregnancy — including intense shoulder pain or pain that doesn’t improve.

Seek urgent care if you suspect an ectopic pregnancy or experience sharp, severe pain. Emergency treatment or surgery may be necessary to prevent complications from an ectopic pregnancy.

Contact your clinician promptly if you have nausea, vomiting, or other signs of preeclampsia in your second or third trimester.

Reducing your risk of shoulder pain in pregnancy

You can’t avoid all aches during pregnancy; occasional shoulder discomfort is a common aspect of gestation.

However, you may be able to reduce the risk of serious complications like preeclampsia. Discuss ways to manage blood pressure during pregnancy with your provider.

Strategies to help maintain balanced blood pressure include:

• staying well-hydrated
• limiting salt intake
• increasing dietary protein
• elevating your feet when possible
• avoiding prolonged standing
• engaging in light daily activity
• steering clear of fast food
• reducing consumption of fried foods

Bottom line

Shoulder pain during pregnancy is common and often caused by normal, mild changes in your body across the trimesters.

Some rarer causes can be serious — such as an ectopic pregnancy early on or preeclampsia in the later trimesters.

Always check with your healthcare provider promptly if you experience sudden, unusual, or severe pain. Tell your doctor about anything that doesn’t feel typical — you know your body best, even while pregnant.